MEDICARE: AURORA COUNSELING & MENTAL HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	I-06342	NM

General Provider Information

NPI Number	:	1720427305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AURORA COUNSELING & MENTAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1233 STUTZ DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-6232
Country	:	US
Telephone Number	:	505-504-6697
Fax Number	:

Provider Business Practice Location Address
First Line	:	1233 STUTZ DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-6232
Country	:	US
Telephone Number	:	505-504-6697
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER/OWNER
Name	:	MS. KATHRYN POPE COCHRAN
Credential	:	LISW
Telephone Number	:	505-573-2024

Provider Enumeration Date	:	06/17/2013
Last Update Date	:	06/17/2013

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